BLOG

In 1993, Colby Cassani, who was only one year old, was left unattended in a bathtub by his babysitter. He slipped under water and drowned. He was rushed to the hospital, but his life could not be saved.
 
A physician at the hospital asked Colby’s parents the difficult question: “Would you be willing to donate your son’s organs?” In spite of their grief, they agreed.
 
Although Colby’s life was short, his legacy touched many lives. His kidneys were transplanted into a twenty-seven year old man. His liver was implanted in a two year old girl. And his heart was donated to a five month-old boy. All of the transplants were successful.
 
The Cassanis established the Colby Foundation in 1995 as a way to honor Colby’s memory and to inspire and educate others about organ and tissue donation. You can read more about the Colby Foundation at www.colbyfoundation.org.
 
Almost anyone can be an organ donor, regardless of age or medical history.
 
You can make a statement regarding organ and tissue donation in your Living Will, on your driver’s license, or in a separate document. You can also give specific direction as to who should benefit from the donation, and may even give certain individuals, such as family members a preference.
 

Yesterday I discussed “Do Not Resuscitate” orders, and explained what they are.
 
One of the most touching stories I have ever heard about a “Do Not Resuscitate” order was told by Dr. Atul Gawande in his best-selling book, Being Mortal.
 
Dr. Gawande is a nationally recognized surgeon. His father, who was also a surgeon, was diagnosed with inoperable cancer when he was in his early 70s. Although everything possible was done for Dr. Gawande’s father, his condition deteriorated to the point that he was confined to bed. He was adamant that he did not want to be in pain, and did not want to be resuscitated.
 
Dr. Gawande’s father eventually began to receive hospice care at his home, and was given medications for comfort. Dr. Gawande’s mother, who is also a doctor, stayed by his side. However, when she couldn’t wake him up and his skin began to turn blue, she panicked and called 911. When Dr. Gawande’s father woke up in the hospital, he was furious!
 
This story illustrates the conflicts associated with “Do Not Resuscitate” orders and end-of-life decisions. Even doctors are not immune to the strong emotions they incite.
 
I highly recommend the video Being Mortal, which was aired on PBS in 2015, and in which Dr. Atul Gawande discusses end-of-life issues in detail.
 

You have probably heard of CPR, or Cardio-Pulmonary Resuscitation. If your heart stops beating or you stop breathing, Cardio-Pulmonary Resuscitation procedures are done to save your life.
 
As a former hospital critical care nurse who has seen many patients resuscitated, and then kept alive for months on life-support in a comatose or vegetative state, I have very strong feelings about “Do Not Resuscitate” orders. For many patients, resuscitation was a great disservice to them, and only prolonged the dying process.
 
We tend to associate “Do Not Resuscitate” orders with elderly people who are terminally ill. However, they are appropriate for anyone with an end-stage terminal illness, including young cancer patients, and even terminally ill children.
 
Unlike a Living Will or Medical Power of Attorney, which are documents that you sign for yourself, a “Do Not Resuscitate” order must be given by your doctor after a consultation. If your doctor does not give a “Do Not Resuscitate” order, medical personnel must administer CPR.
 
If you have a “Do Not Resuscitate” (DNR) order, you should display it on the front door of your home or on the refrigerator, so that emergency medical personnel can find it easily. If you are a patient in a health care facility, your doctor will put a “Do Not Resuscitate” (DNR) order on your chart.
 
Like all advance medical directives, a DNR order can be revoked at any time. They do not apply to other kinds of medical care, such as treatment for pain, bleeding, or broken bones. They only apply to resuscitation procedures, like chest compressions and breathing tubes.
 
If you, or a loved one, is facing a life-threatening illness, I highly recommend the video Being Mortal, which was aired on PBS in 2015, and in which Dr. Atul Gawande discusses end-of-life issues in detail.
 

A Medical or Health Care Power of Attorney is a document that names the person you want to make medical decisions for you when you cannot make them for yourself.
 
The story of Forrest Stone illustrates why a Medical Power of Attorney is so important. (This incident happened in Virginia, but it could just as easily have happened in Colorado.)
 
Forrest was an 18 year old high school student when a snowboarding accident sent him to the hospital in critical condition. He was in a coma and on a ventilator in the intensive care unit. Surgeons actually had to remove the front third of his skull so that his brain could swell without causing further damage.
 
Legally, Forrest was an adult. Under HIPAA, the Health Insurance Portability and Accountability Act, his medical issues were none of his parents’ business, even if he was still covered by their insurance.
 
As her son lay in a coma, Forrest’s mother had to hire an attorney and appear in court for a “mini trial” to get legal guardianship to make medical decisions for her son. The court even sent a guardian ad litem to the hospital to read the proposed legal documents to Forrest while he was in a coma, and find out if he had any objections. Ultimately, Forrest’s mother got guardianship of her son, but it was costly, time-consuming, and emotionally draining.
 
Every adult should have a Medical Power of Attorney, because we never know what the future holds.
 
Unlike a Living Will, your Agent’s authority does not just apply when you are terminally ill or in a persistent vegetative state. It applies in every situation when you are unable to make medical decisions for yourself. However, your Agent must carry out the wishes expressed in your Living Will if you have one.
 
If you have questions about Medical Powers of Attorney, please call my office.